A Multicentre Study of Abdominal Aorta Diameters in a Turkish Population (original) (raw)
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The epidemiology of abdominal aortic diameter
Journal of Vascular Surgery, 2008
Background: The diameter of the abdominal aorta is central to the diagnosis of abdominal aortic aneurysm. This study aimed to determine the associations between the diameter of the abdominal aorta at three distinct locations and the traditional cardiovascular disease risk factors as well as calcified atherosclerosis. Methods: A total of 504 patients (41% women) underwent whole body scanning by electron beam computed tomography (EBCT) and a standardized assessment for cardiovascular disease risk factors. The resulting EBCT images were retrospectively interrogated for the diameter of the abdominal aorta just inferior to the superior mesenteric artery (SMA), just superior to the aortic bifurcation, and at the midpoint between the SMA and bifurcation. Results: Mean patient age was 57.8 years. The mean (SD) diameter was 21.3 (2.9) mm at the SMA, 19.3 (2.5) mm at the midpoint, and 18.6 (2.2) mm at the bifurcation. In a model containing the traditional cardiovascular disease risk factors, age (standardized  ؍ 0.96), male sex ( ؍ 3.06), and body mass index (standardized  ؍ 0.68) were significantly associated with increasing aortic diameter at the SMA (P < .01 for all). The significance of the associations for these variables was the same for aortic diameter at the midpoint and bifurcation. Furthermore, a 1-unit increment in the calcium score in the abdominal aorta and iliac arteries was associated with 0.13-mm (P < .01) and 0.09-mm (P ؍ .02) increases, respectively, in aortic diameter at the SMA. The results were similar for the midpoint ( ؍ 0.19, P < .01;  ؍ 0.12, P ؍ .01, respectively) and bifurcation ( ؍ 0.09, P < .04;  ؍ 0.09, P ؍ .03, respectively).
European Journal of Vascular and Endovascular Surgery, 2010
We aim to study whether the diameter of the non-aneurysmatic infrarenal aorta influences the risk for abdominal aortic aneurysm (AAA) and whether the larger diameter in men can explain the male predominance in AAA. Design: This is a population-based follow-up study. Materials and methods: In 4265 men and women with a normal-sized aorta in 1994-1995, 116 incident cases of AAA were diagnosed 7 years later. The risk of an incident AAA was analysed in a multiple logistic regression model according to baseline maximal infrarenal aortic diameter, adjusted for known risk factors. Results: Compared with subjects with aortic diameter in the 21-23 mm bracket, men and women with a diameter <18 mm and 27 mm had an adjusted odds ratio (OR) of 0.30 (95% confidence interval (CI): 0.10e0.88) and 4.22 (95% CI: 1.94e9.19), respectively, for an incident AAA. When adjusted for age and baseline aortic diameter, male sex was not statistically significantly associated with the incidence of AAA (OR Z 1.45, 95% CI: 0.93e2.30, P Z 0.10). Conclusions: Increased baseline diameter of the infrarenal aorta was a highly significant, strong and independent risk factor for developing an AAA. The larger aortic diameter in men than in women may be the most important explanation for the higher AAA risk in men.
Journal of Vascular Surgery, 2008
Objective: The aim of this population-based study was to determine the optimal dividing-line between normal aorta and aneurysm for different aortic segments in 70-year-old men and women by means of whole-body magnetic resonance imaging. Methods: Two hundred thirty-one subjects (116 men), randomly recruited from a population-based cohort study, were included. The smallest outer diameter (dia) was measured on the axial survey scan on six predefined aortic segments: (1) ascending aorta, (2) descending aorta, (3) supraceliac aorta, (4) suprarenal aorta, (5) largest infrarenal abdominal aorta, and (6) aortic bifurcation. Relative aortic dia were calculated by dividing a given aortic dia by the suprarenal aortic dia. The dividing-line between normal aorta and aneurysm at different aortic segments was estimated by taking the mean dia ؉2 SD and/or mean ratio of the aortic segment to the suprarenal aorta ؉2 SD.
European Journal of Vascular and Endovascular Surgery, 2004
Objective. To assess agreement between ultrasound and computed tomography (CT) measurements from axial images of normal and aneurysmatic aortic and common iliac artery diameter. Design. Part of a population health screening for abdominal aortic aneurysm conducted in 1994-1995. Materials and methods. Three hundred and thirty-four subjects with and 221 subjects without ultrasound-detected aneurysm were scanned with CT. Three technicians and one radiologist measured ultrasonographic diameters and five radiologists measured CT diameters. The paired ultrasound-CT measurement differences were analyzed to assess agreement. Results. Compared to CT measurements, ultrasound slightly underestimated the diameter in normal aortas and tended to overestimate the diameter in aneurysmal aortas. In 555 ultrasound-CT pairs of measurements, the absolute differences for measurements of maximal aortic diameter were 2 mm or less in 62, 60 and 77% in anterior -posterior, transverse and maximum diameter in any plane, respectively. The corresponding figures for an absolute difference of 5 mm or more were 14, 18 and 8%, respectively. Variability increased with increasing diameter. Conclusions. Both ultrasound and CT measurements of abdominal aortic diameter are liable to variability and neither of these methods can be considered to be 'gold standard'. Both methods can be used, while taking variability into consideration when making clinical decisions.
Aortoiliac Diameter and Length in a Healthy Cohort
2021
Objective: Diameter is currently the only screening and diagnostic criterion for asymptomatic aneurysms. Therefore, aortic and lower-extremity arterial diameter has diagnostic, therapeutic, and prognostic importance. We aimed to determine aortic and lower-extremity arterial reference diameters in a general population and compare them according to age, sex, and other characteristics.Methods: We evaluated consecutive 3,692 patients who underwent computed tomography as part of a general health checkup from 2015–2019 in a single tertiary center. Aortic and lower-extremity arterial diameters and the most important factor related to arterial diameters were evaluated.Results: The mean diameter of the abdominal aorta was 17.490 ± 2.110 mm, while that of the common iliac artery was 10.851 ± 1.689 mm. The mean diameter of the abdominal aorta was 18.377 ± 1.766 mm in men and 15.884 ± 1.694 mm in women. Significant intersex differences were observed for all mean diameters and lengths. Multiline...
A dynamic view on the diameter of abdominal aortic aneurysms
European Journal of Vascular and Endovascular Surgery, 1998
Objectives: To study 40-55 mm aneurysms and calculate their size in relation to the individual predicted normal aortic diameter to see if this might add anything in the evaluation of treatment. Material and methods: The anteroposterior diameter of 40-55 ,mm AAAs was measured with an echo-tracking ultrasonic technique in 147 consecutive patients. The weight and height were registered and body surface area calculated. The predicted normal aortic diameters were defined according to nomograms and the diameter increase from the predicted normal aortic size in the individual aneurysms calculated. Results: The median AAA diameter was 48 mm (range 40-55), the BSA 1.85 m 2 (1.42-2.37), and the predicted AO size 19.4 mm (14.3-21.6). The calculated increase of size in the individual aneurysms was 2.51 (1.9-3.53), that is the spread of data doubled as compared to conventional diameter measurements. When females and males were studied separately the AAA diameter was 46.5 mm (40-55) and 48 mm (40-55), respectively (NS). Since the BSA was significantly lower in women than in men, 1.63 (1.42-1.95) and 1.89 (1.47-2.37), respectively (p<O.O001), also the predicted normal aortic size was lower, 16.4 (14.3-17.8) vs. 19.7 (18.0-21.6) (p<O.O001). Thus, the AAA diameter increase from the predicted size was larger in women than in men; 2. 93 (2.25-3.53) vs. 2.46 (1.90-2.94), respectively (p<O.O001). Conclusion: To define an aneurysm as a localised dilatation of an artery exceeding 50% of the expected normal diameter is now possible. This may facilitate how to treat especially smaller aneurysms and give new information concerning patterns of growth and risk of rupture.
European Journal of Radiology, 2013
Purpose: To use US to evaluate the normal values of aortic diameter (AD), stratifying the population by age, gender and body build, as measured using wrist circumference (WC). Materials and methods: Between April 2010 and February 2012, consecutive patients ≥ 30 years of age, without history of abdominal aortic aneurysm (AAA) were prospectively enrolled. They underwent an abdominal ultrasonography for reasons other than aorta evaluation. AD was measured at the infrarenal (AD 1 ), intermediate (AD 2 ), and iliac bifurcation (AD 3 ) levels: a diameter ≥ 3 cm was considered as an aneurysm. The maximal aortic diameter (AD max ) was measured for AAA patients. WC was measured; AD/WC ratio was calculated and presented in percentage: the range of normal values was obtained excluding AAA cases and calculated as mean ± 1.96 × standard deviation. Pearson correlation coefficient was used. Results: We recruited 1200 patients, 15 (1.25%; age range = 64-86 years) had AAA. AD ranges of the other patients were: AD 1 = 0.74-1.84 cm, AD 2 = 0.78-1.85 cm, and AD 3 = 0.68-1.76 cm for females; AD 1 = 0.86-2.02 cm, AD 2 = 0.91-2.08 cm, and AD 3 = 0.84-1.95 cm for males. AD 2 /WC ratio of non-AAA patients range was 4-15%, with only one outlier at 18%, while AD max /WC ratio of AAA patients range was 15-35% (p < 0.001). ADs were significantly correlated with WC (r = 0.253, p < 0.001 for AD 1 , r = 0.318, p < 0.001 for AD 2 and r = 0.280, p < 0.001 for AD 3 ). Conclusion: The definition of normal AD should consider body build. An AD 2 /WC ratio of 15% may be regarded as a threshold to differentiate AAA-from non-AAA patients. Patients with AD 2 /WC values comprised between 12% and 15% may be at risk for AAA.
The cardiovascular and prognostic significance of the infrarenal aortic diameter
Journal of Vascular Surgery, 2011
The normal aortic diameter in adults usually ranges from 16 to 18 mm in women and 19 to 21 mm in men. Individuals with diameters outside this range seem to be at increased risk of other cardiovascular disease. There is a graded association between increasing aortic diameter and both cardiovascular mortality and peripheral arterial disease. The magnitude of increased risk of cardiovascular death seems to be about 4% to 6% per mm increase over a diameter of about 23 mm. To a lesser extent, these outcomes are also increased in individuals with aortic diameters below the normal range. While the threshold of 3 cm is useful in the diagnosis of abdominal aortic aneurysm (AAA), it is arbitrary in terms of the vascular biology and pathophysiology of the abdominal aorta. This review examines the risk factors for aortic enlargement and the cardiovascular implications of this enlargement in patients with and without AAAs. The mechanisms underlying the association between aortic diameter and cardiovascular risk and the relevance to screening are also discussed. ( J Vasc Surg 2011;54:1817-20.)